Abstract
Left ventricular thrombus (LVT) represents a potential life-threatening condition
burdened by a significant risk of systemic embolism. Despite the relevance of the
disease, there are scanty data on antithrombotic management of LVT mostly deriving
from small observational studies and few randomized controlled trials. It has been
reported that anticoagulant therapy reduces the rate of thrombus formation, allows
thrombus resolution in most cases, and limits the risk of embolic complications. Several
issues, however, still remain unresolved and clinicians caring for these patients
have to decide on the need and on the regimen of antithrombotic therapy based on their
expertise and data from different clinical scenario. This position paper of the Italian
Society of Hemostasis and Thrombosis (SISET) aims to provide practical advice and
guidance in the form of text, tables, and figures for clinicians dealing with LVT.
Relevant clinical questions related to LVT have been identified concerning the identification
of patients at risk; the role of anticoagulant prophylaxis on LVT development; the
type, dose, and duration of anticoagulant therapy; and the management of patients
receiving concomitant antiplatelet therapy. A systematic search has been performed
to identify available evidence on the topic that has been carefully and critically
reviewed by the national expert authors to support the suggestions and recommendations.
Keywords
acenocoumarol - anticoagulants - heparin - venous thromboembolism - warfarin
